Plan Benefit Package

Leverage the Power of a Centralized Source of Truth®

Plan Benefit Information has a variety of uses—CMS bid review/approval, Medicare Plan Finder, member materials (ANOCS, EOCs, SBs/SOBs, SBCs), customer service, sales, appeals and grievances, claims, and more. However, this information is typically housed in multiple locations and managed independently by various departments, making it difficult to update and maintain accuracy.

The CodySoft® Plan Benefit Package Module® streamlines the population of plan benefit data into a single Centralized Source of Truth®—saving time, improving accuracy, and reducing compliance risk in the plan benefit table and final documents. The module imports plan data through the ingestion of XML PBP reports, and other companion data that is stored in separate tables. User-defined rules apply logic to auto-transform data upon import, while allowing for further overrides of the data to produce more customized output.

Plan Benefit Package

The resulting Centralized Source of Truth® can be exported in multiple formats and used enterprise-wide in the development of ANOC/EOC/SB materials and other document applications such as call center benefit scripts, required notices, member outreach, provider education materials, and much more.

Revolutionizing the Way Health Plans Manage Data

We understand the challenges plans face and the intricacies of trying to manage benefit data. Compared to the limited number of other products in the marketplace, CodySoft’s Plan Benefit Package Module® is the most cost-effective and best designed solution out there. There is no other product today that manages all the different data structures and provides it in a universal format. This is truly revolutionary!

Client Testimonial:

“With CodySoft® CM & PBP modules, our team was able to develop & fulfill over 46,000 plan documents for over 480 unique plans—Individual & Family (on & off-exchange), Small & Large Group plans.

An efficient process is essential for all Plan documents—SBCs, EOCs, COCs, Benefits Booklets, Medicare & Custom Group documents—to ensure accuracy & compliance with State & CMS regulations.”

Leading MA & Commercial Group Plan in the Southwest

With the Plan Benefit Package Module®, You Can:

  • Mitigate compliance risk from manual benefit grid maintenance
  • Leverage automation to save time and money
  • Import PBP xml reports and companion data, define the data structure and rules to auto-transform the data, and export the PBP Reports and Master Data Grids as Excel and PDF files
  • Easily retrieve a real-time enterprise-wide data grid to support contract tables, Low Income Subsidy (LIS) tables, marketing tables, operational data and more
  • Ensure accuracy in member marketing and communications materials (such as ANOCs, EOCs, and SBs)
  • Access a Medicare Plan Finder preview in a format that allows for easy reviews
  • Increase consistency between PBP descriptions of benefits and call center benefit scripts
  • Enhance claims processing through a system configuration that verifies that the claim programming matches the approved benefits
  • Delegate set-up, testing and monitoring of claims processing
  • Enhance the product design process through reports and tracking of benefit trends and costs